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Clostridium difficile in a healthcare worker
Letters
322
to the Editor
Sir, Clostridium
difficile
in a healthcare
worker
Diarrhoea caused by Clostridium difficile is a hospital-acquired infection which can spread from patient to patient. Symptomatic C. difficile infection in healthcare workers (HCWs) has been rarely reported.‘-3 We report a case in which a healthcare worker acquired symptomatic C. difficile infection when there was a low level of C. difJiciZe infection in the hospital as a whole. The HCW involved was looking after 45 surgical patients on two surgical wards. Two of these patients had symptomatic infections owing to C. dif$cile. There were no other known cases of C. difficile infection in the hospital. The HCW had recently taken amoxycillin for a respiratory tract infection but was back at work. Two days after first contact with these patients the HCW developed profuse diarrhoea, and a stool specimen examined that day was positive for C. difficile toxin A. The HCW was off work for five days whilst the diarrhoea settled. No other bacterial pathogens were isolated. In line with recommendations for investigation of C. difficile, we did not culture for C. difficiZe from the patients or the HCW. There are probably many HCWs, taking antibiotics for a variety of relatively minor indications, who are in contact with patients excreting toxin positive C. difjkile. We recommend all HCWs to pay careful attention to hand hygiene after contact with any patient with diarrhoea. Sandwell Healthcare
Trust, Lyndon, West Bromwich, West Midlands, UK
N. Kaplan A. Davies P. Davies
References 1. Tabaqchali S, Jumaa P. Diagnosis and management of Clostridium difficile infection. BMJ 1995; 310: 1378-80. 2. Cartmill TDI, Panigrahi H, Worsley MA, McCann C, Nice CN, Keith E. Management and control of a large outbreak of diarrhoea due to Clostridium dif$cile. J Hasp Infect 1994; 27: 1-15. 3. Strimburg MO, Sacho H, Berkowitz1 I. Clostridium dif$cile in healthcare workers. Lancet 1989; ii: 66-7.
322
to the Editor
Sir, Clostridium
difficile
in a healthcare
worker
Diarrhoea caused by Clostridium difficile is a hospital-acquired infection which can spread from patient to patient. Symptomatic C. difficile infection in healthcare workers (HCWs) has been rarely reported.‘-3 We report a case in which a healthcare worker acquired symptomatic C. difficile infection when there was a low level of C. difJiciZe infection in the hospital as a whole. The HCW involved was looking after 45 surgical patients on two surgical wards. Two of these patients had symptomatic infections owing to C. dif$cile. There were no other known cases of C. difficile infection in the hospital. The HCW had recently taken amoxycillin for a respiratory tract infection but was back at work. Two days after first contact with these patients the HCW developed profuse diarrhoea, and a stool specimen examined that day was positive for C. difficile toxin A. The HCW was off work for five days whilst the diarrhoea settled. No other bacterial pathogens were isolated. In line with recommendations for investigation of C. difficile, we did not culture for C. difficiZe from the patients or the HCW. There are probably many HCWs, taking antibiotics for a variety of relatively minor indications, who are in contact with patients excreting toxin positive C. difjkile. We recommend all HCWs to pay careful attention to hand hygiene after contact with any patient with diarrhoea. Sandwell Healthcare
Trust, Lyndon, West Bromwich, West Midlands, UK
N. Kaplan A. Davies P. Davies
References 1. Tabaqchali S, Jumaa P. Diagnosis and management of Clostridium difficile infection. BMJ 1995; 310: 1378-80. 2. Cartmill TDI, Panigrahi H, Worsley MA, McCann C, Nice CN, Keith E. Management and control of a large outbreak of diarrhoea due to Clostridium dif$cile. J Hasp Infect 1994; 27: 1-15. 3. Strimburg MO, Sacho H, Berkowitz1 I. Clostridium dif$cile in healthcare workers. Lancet 1989; ii: 66-7.